No - but some have very difficult jobs, as does anyone dealing with the public. It is a different world for them, and DH (an MD) counsels our DC NOT to go into medicine. I don't know how anyone works in an urban ER anymore.

Anonymous wrote:

Anonymous wrote:Of course they're not altruistic. The hardest to get specialities are ROAD 2 riches, as they're high paying and easy hours. If they were altruistic, family practice and internal medicine wouldn't be struggling to find providers.

But, most doctors are family practice, and pediatrics, and internal medicine.

I have a pediatrician in my family and most of our friends are doctors. Of those, a vast majority are family medicine or some sort of pediatrics. They are all good people who work long hours and are not paid very much compared to their surgeon peers.

The surgeons we know also work long hours but are paid very well and are generally pricks. The shortage of people willing to go into family medicine is driving some of the salaries higher where I live, but still doesn't compare to an adult specialist salary.

Anonymous wrote:Of course they're not altruistic. The hardest to get specialities are ROAD 2 riches, as they're high paying and easy hours. If they were altruistic, family practice and internal medicine wouldn't be struggling to find providers.

But, most doctors are family practice, and pediatrics, and internal medicine.

Of course they're not altruistic. The hardest to get specialities are ROAD 2 riches, as they're high paying and easy hours. If they were altruistic, family practice and internal medicine wouldn't be struggling to find providers.

A bunch of what you describe would be clear medical malpractice.

Anonymous wrote:

Anonymous wrote:I am an attorney who specializes in working with doctors and insurance plans to negotiate reimbursement levels. I am daily shocked at doctors, though I shouldn’t be anymore. I would say the majority of mental health providers that begin the negotiation process stop it and say they’d rather have high, private pay patients than deal with other people who need any type of insurance. With such a lack of in network providers, it’s always disheartening. And I’ll say, the reimbursement levels offered from plans are high (in my experience). The docs just claim they can get 4x that with a small (rich) subset of people.

My former therapist used to go on about how evil insurance companies are and why she, therefore, was a saint for refusing to work with them. The message rang a bit hollow when we were sitting in her fancy home office in Chevy Chase.

This is so true. I had a therapist as well that lauded the goals of a single payer system to create more equity. However, she was cash only. I asked what she would do if we ever had that type of a system and she just laughed and said it wouldn’t hurt her as she’d operate outside the system on a cash only basis. I honestly don’t think she got the irony of her statement.

A lot of doctors are formerly altruistic medical students who were worked to the bone during the second half of med school and however long their residencies were. They came out of it bitter.

Anonymous wrote:I am an attorney who specializes in working with doctors and insurance plans to negotiate reimbursement levels. I am daily shocked at doctors, though I shouldn’t be anymore. I would say the majority of mental health providers that begin the negotiation process stop it and say they’d rather have high, private pay patients than deal with other people who need any type of insurance. With such a lack of in network providers, it’s always disheartening. And I’ll say, the reimbursement levels offered from plans are high (in my experience). The docs just claim they can get 4x that with a small (rich) subset of people.

My former therapist used to go on about how evil insurance companies are and why she, therefore, was a saint for refusing to work with them. The message rang a bit hollow when we were sitting in her fancy home office in Chevy Chase.

A lot of doctors are jerks, especially surgeons.

Every profession has good and bad people. Most are just trying to make a living. Like PP said, there's no requirement that anybody be altruistic: it's a job. But medicine does attract or create some real mean personalities.

I am an attorney who specializes in working with doctors and insurance plans to negotiate reimbursement levels. I am daily shocked at doctors, though I shouldn’t be anymore. I would say the majority of mental health providers that begin the negotiation process stop it and say they’d rather have high, private pay patients than deal with other people who need any type of insurance. With such a lack of in network providers, it’s always disheartening. And I’ll say, the reimbursement levels offered from plans are high (in my experience). The docs just claim they can get 4x that with a small (rich) subset of people.

Check out r/residency on reddit and you'll see just how scummy they are.

Anonymous wrote:Why should doctors at a hospital get paid differently depending on which patients they see? I know that’s how it works, but this demonstrates why maybe it shouldn’t be that way.

Because medical school is cripplingly expensive and residents are drastically underpaid. We want poor people to get medical care, but we are not will to pay enough in taxes to give doctors reimbursement rates comparable to what they get from old people let alone from people with decent insurance or out of network. The end result is that their pay depends on the patients they see. At least for procedures in a hospital, the level of care is roughly the same regardless of care. For people seeing internists for routine appointments, the difference in the level of care between a doctor who accepts no insurance and a doctor willing to take medicaid patients is going to be vast

Why should doctors at a hospital get paid differently depending on which patients they see? I know that’s how it works, but this demonstrates why maybe it shouldn’t be that way.

Of course not. That is why so many go in to high paying specialties instead of low-reimbursed things like family med.

But they are very important and I am glad we have them. No need to be altruistic. Just do a good job.

We hold doctors on such high pedestals in this country. My best friend is chief surgeon, and the stories he tells about his docs are truly shocking. He says it is extremely common to have to reprimand his docs who try to get info on their patients' insurance first to see if they'll get a good payment from them. If they have something crappy like medicaid or some other terrible insurance, my friend says docs will initially diagnose a patient with something else that is very closely related to what they know the person has. That way they can avoid having to do surgery on the patient and pass the buck to someone else later who'll get stuck with the patient with crappy insurance. My friend has to routinely make sure that when he is on duty that his docs treat everyone who comes in like they have the same exact insurance so these shenanigans don't go on, but the point here is that how often do things like this go on elsewhere where they don't have chiefs who do ethical jobs who look the other way. How many scummy docs are out there looking to soak as much money as they can out of the system and refuse their services for someone who needs it if they know that the patient's insurance will pay lower rates.